Provider Demographics
NPI:1124696455
Name:MARTINEZ TORRES, DENISSE (RBT)
Entity type:Individual
Prefix:
First Name:DENISSE
Middle Name:
Last Name:MARTINEZ TORRES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 W 35TH ST APT 22A
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-8603
Mailing Address - Country:US
Mailing Address - Phone:786-707-7490
Mailing Address - Fax:
Practice Address - Street 1:1225 W 35TH ST APT 22A
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-8603
Practice Address - Country:US
Practice Address - Phone:786-707-7490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT21-170446106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician